To get message across, doctors should focus on sun's damage to looks, not health, panel advises.

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MONDAY, May 7,
2012 (HealthDay News) — Doctors should take the time
to counsel children, teens
and young adults on the dangers of sun exposure and tanning
beds, according to new recommendations from the U.S. Preventive
Services Task Force.

But rather than focus on skin cancer,
discussions with young patients should center on how ultraviolet-ray exposure
can damage the way their skin looks, the task force advised.

"We are not saying to
young people to avoid sun exposure and indoor tanning to prevent skin cancer,
because that message doesn't work," said Dr. Virginia Moyer, USPSTF chair
and a professor of pediatrics at Baylor College of Medicine in Houston.

"That is the goal, but
the message that works is to use appearance-based counseling," she said.

Because most research so
far is based on people with fair skin — who are at the greatest risk
of skin cancer — these new recommendations apply only to them, the
authors noted.

Instead of telling these
patients about the risk of skin cancer, they should be told that sun exposure
leads to ugly skin:
"What you end up having is wrinkled, leathery skin," Moyer said.

"If the audience you
are trying to reach is young people whose concern about having skin cancer is
not very high, then the more effective way to get the message across is to talk
about the more immediate effects — skin damage," she said.

For example, doctors can
show patients photos taken of skin with a UV camera to demonstrate the damage
UV rays can cause.

The recommendations
appeared online May 8 in advance of publication in the July 3 print issue in
the Annals of Internal Medicine.

Specifically, doctors
should counsel children, teens and young adults aged 10 to 24 who have fair
skin and no history of skin cancer about skin cancer prevention. Having light
skin, hair and eyes increases the risk for skin cancer, as does overexposure to
ultraviolet rays at an early age, the recommendations state.

Skin cancer affects more
than 2 million Americans each year, according to background information from
the USPSTF.

This recommendation is a
change from the group's previous statement, which said that evidence was
insufficient to be able to make a recommendation at that time, Moyer said.

"We now have data that
is pretty good that counseling adolescents and young adults who are
fair-skinned to avoid sun exposure, using counseling that is appearance-based,
works," she said.

Moyer noted that early skin
damage is a precursor to skin cancer later in life. "But by the time
people are concerned about the risk of skin cancer it's too late. The damage
has been done," she explained.

Appearance-based counseling
by doctors can change behavior, Moyer said. "It should be part of
well-person exams for fair-skinned people," she added.

Right now there is not
enough evidence to recommend counseling adults about the dangers of UV
exposure, the report noted.

Dr. Jeffrey Salomon, an
assistant clinical professor of plastic surgery at Yale University School of
Medicine, said he isn't convinced that counseling children is enough to get
them into the habit of protecting themselves from UV exposure.

"It is always a
challenge to change people's behaviors," he said. Counseling and media
campaigns aren't enough. These changes must be taught early, Salomon added.

In Australia, schools have
an integrated program about sun protection, a large media campaign and
widespread availability of sun-protection clothing and other products, he
pointed out. Yet, studies show that even in Australia, the country with the
highest incidence of dangerous skin cancers, media announcements only have
short-term benefits in getting people to comply, he noted.

"I think that there is
a clear parental responsibility to protect one's child from the largest-known
cancer risk: the sun," Salomon said.

He noted that parents make
their children wear bike helmets and buckle seat belts and they don't leave
their children unattended.

"If children are
slathered with sun-protection creams and not brought out in the midday sun, it
will ultimately seem to be the normal and prudent thing to do," Salomon
said.

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